Cognitive bias and attitude distortion of a priority decision.

The resource saving bias is a cognitive bias describing how resource savings from improvements of high-productivity units are overestimated compared to improvements of less productive units. Motivational reasoning describes how attitudes, here towards private/public health care, distort decisions based on numerical facts. Participants made a choice between two productivity increase options with the goal of saving doctor resources. The options described productivity increases in low-/high-productivity private/public emergency rooms. Jointly, the biases produced 78% incorrect decisions. The cognitive bias was stronger than the motivational bias. Verbal justifications of the decisions revealed elaborations of the problem beyond the information provided, biased integration of quantitative information, change of goal of decision, and motivational attitude biases. Most (83%) of the incorrect decisions were based on (incorrect) mathematical justifications illustrating the resource saving bias. Participants who had better scores on a cognitive test made poorer decisions. Women who gave qualitative justifications to a greater extent than men made more correct decision. After a first decision, participants were informed about the correct decision with a mathematical explanation. Only 6.3% of the participants corrected their decisions after information illustrating facts resistance. This could be explained by psychological sunk cost and coherence theories. Those who made the wrong choice remembered the facts of the problem better than those who made a correct choice.